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General NPI Number Information
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NPI Number | 1134087158
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Entity Type | Organization
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Legal Business Name | PURPOSE PEER & THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 3626 WESTERN BRANCH BLVD
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City | PORTSMOUTH
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State | VA
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Zip | 23707-2534
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Country | US
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Telephone | 757-799-8486
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Fax | 757-799-8486
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Provider Business Mailing Address
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Address Line | 3626 WESTERN BRANCH BLVD
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City | PORTSMOUTH
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State | VA
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Zip | 23707-2534
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Country | US
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Telephone | 757-799-8486
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Fax | 757-799-8486
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Authorized Official
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Title or Position | CEO
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Name | GEROD STUKES
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Credential | CSAC, QMHPA/C, R-CPR
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Telephone | 757-799-8486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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